1. © 2014 APC/API/CAP. All rights reserved. Pathology Informatics: Residency Curriculum for Now and the Future West and Midwest Chairs and Administrators Regional Conference October 21 - 24, 2014

2. © 2014 APC/API/CAP. All rights reserved. Informatics Training in Pathology “The landscape of medical practice is changing… Appropriate exposure to and training in informatics will be essential…Developing a strong informatics component for residency training programs will help advance the transformational future of the practice of medicine.” 2 Sinard JH, Powell SZ, Karcher DS. Pathology training in informatics: Evolving to meet a growing need. Arch Pathol Lab Med 2014 (April);138:505-511.

3. © 2014 APC/API/CAP. All rights reserved. What is PIER? Pathology Informatics Essentials for Residents Collaborative joint project of APC, API and CAP Instructional resource guide and toolkit Support for PRODS to address unmet needs for pathology informatics training Mapped to ACGME milestones in informatics for pathology residents 3

4. © 2014 APC/API/CAP. All rights reserved. PIER Developed by Pathology Informatics Experts and PRODS 4 Core Team Drs. Walter Henricks and Liron Pantanowitz (co-leaders) Dr. Donald KarcherPriscilla MarkwoodAnn NeumannSue Plath Working Group Dr. Raymond D. AllerDr. Suzanne Zein-Eldin Powell Dr. Philip J. BoyerDr. Michael Warren Riben Dr. Victor Borisovich BrodskyDr. Rodney A. Schmidt Dr. Alexis B. CarterDr. John H. Sinard Dr. Rajesh C. DashDr. Enrique Terrazas Dr. Michael D. FeldmanDr. J. Allan Tucker Dr. John R. GilbertsonDr. J. Mark Tuthill Dr. James H. Harrison, JrDr. Myra L. Wilkerson Dr. Anil V. Parwani

5. © 2014 APC/API/CAP. All rights reserved. Residents Receive uniform, high quality training in a flexible and timely manner Gain essential pathology informatics knowledge and skills Be well-prepared to apply pathology informatics to collect, manage and share key medical information with colleagues and patients Program Directors Receive: Up-to-date content suitable for AP &/or CP Scalable design based on program characteristics and needs User-friendly toolkit for flexible implementation Content updates/releases Relevant performance outcomes mapped to ACGME milestones 5 Benefits Slide builds in 4 clicks

6. © 2014 APC/API/CAP. All rights reserved. PIER Release Plan Release 0 –Introduced at July 2014 APC Annual Meeting –Illustrated design, content and support features Release 1 –Available now on APC PIER web page –Will be alpha tested starting in November –Available for use by all residency programs during alpha testing 6 Slide builds in 1 click

7. PIER Scope and Sequence 7

8. © 2014 APC/API/CAP. All rights reserved. The PIER Essentials Align to ACGME Informatics Milestones 8 SBP7: Informatics: Explains, discusses, classifies, and applies clinical informatics (APCP) Has not Achieved Level 1 Level 1Level 2Level 3Level 4Level 5 Demonstrates familiarity with basic technical concepts of hardware, operating systems, and software for general purpose applications. Understands lab specific software, key technical concepts and subsystems on interfaces, workflow, barcode applications, automation systems (enterprise systems architecture). Applies informatics skills as needed in project management (data management, computational statistics). Participates in operational and strategy meetings, apprentices troubleshooting with IT staff, applies informatics skills in laboratory management and integrative bioinformatics (able to aggregate multiple data sources and often multiple data analysis services). Is proficient in medical informatics systems. Able to assess and purchase a laboratory information system for anatomic and/or clinical pathology laboratories. Able to utilize medical informatics in the direction and operation of the laboratory. Comments:

9. © 2014 APC/API/CAP. All rights reserved. PIER Scope and Sequence 9 PIER Essentials 1 PIER Essentials 3PIER Essentials 4 PIER Essentials 2 Informatics in Pathology Practice Information Systems Fundamentals Importance of Databases Introduction to Data Standards Data Availability & Security LIS Components & Functions Specialized LISs & Middleware Data & Communication Standards Digital Imaging Basics of the Health Care Information Ecosystem Pathologist Role in LIS & EHR Projects LIS Installation & Configuration Information Systems & Laboratory Performance Data Security, Regulatory & Accreditation Requirements LIS Management & Oversight Order and Results Management Laboratory Data for Quality Improvement & Research Laboratory Data & Enterprise Health Care Analytics Entry-Level Proficiency ACGME Milestone Level 1 Instructional Hours: 4-6 Basic Proficiency ACGME Milestone Level 2 Instructional Hours: 8-10 Intermediate Proficiency ACGME Milestone Level 3 Instructional Hours: 10-12 Advanced Proficiency ACGME Milestone Level 4 Instructional Hours: 10-14

10. © 2014 APC/API/CAP. All rights reserved. PIER Essentials 1 10 PIER Essentials 1 Informatics in Pathology Practice Information Systems Fundamentals Importance of Databases Introduction to Data Standards Data Availability & Security Entry Level Proficiency ACGME Milestone Level 1 Instructional Hours: 4-6

11. © 2014 APC/API/CAP. All rights reserved. PIER Essentials 2 11 PIER Essentials 2 LIS Components & Functions Specialized LISs & Middleware Data & Communication Standards Digital Imaging Basics of the Health Care Information Ecosystem Basic Proficiency ACGME Milestone Level 2 Instructional Hours: 8-10

12. © 2014 APC/API/CAP. All rights reserved. PIER Essentials 3 12 PIER Essentials 3 Pathologist Role in LIS & EHR Projects LIS Installation & Configuration Information Systems & Laboratory Performance Data Security, Regulatory & Accreditation Requirements Intermediate Proficiency ACGME Milestone Level 3 Instructional Hours: 10-12

13. © 2014 APC/API/CAP. All rights reserved. PIER Essentials 4 13 PIER Essentials 4 LIS Management & Oversight Order and Results Management Laboratory Data for Quality Improvement & Research Laboratory Data & Enterprise Health Care Analytics Advanced Proficiency ACGME Milestone Level 4 Instructional Hours: 10-14

14. © 2014 APC/API/CAP. All rights reserved. Scope of Content Out of Scope Statistics Bioinformatics Programming 14 In Scope PIER topics cover what all pathologists need to know for practice Content will be maintained to accommodate changing technologies Slide builds in 1 click

15. PIER Resource Toolkit 15

16. © 2014 APC/API/CAP. All rights reserved. Overview PIER Scope and Sequence –Identifies the “what” to teach PIER Resource Toolkit –Identifies the “how” to teach Programs have unique needs and approaches –Toolkit helps PRODS scale topics –Provides implementation options to meet program needs –Helps PRODS make good training decisions 16 Slide builds in 1 click

17. © 2014 APC/API/CAP. All rights reserved. Organization There are 3 key tools for each of the PIER Essentials: –Essentials Map –Resource Options –Outcomes Achievement Checklist 17

18. © 2014 APC/API/CAP. All rights reserved. Essentials Map Top area –Main topics –Rationale –Outcomes for achievement –Topic content Lower area Implementation strategies Scheduling/progress tracker 18

19. © 2014 APC/API/CAP. All rights reserved. Essentials 1 Map: Top Area Topic Title Informatics in Pathology Practice Information Systems Fundamentals Importance of Databases Introduction to Data Standards Data Availability & Security Rationale The practice of pathology relies on the creation, management, and accurate and timely communication of clinical laboratory information. Computers are essential tools that pathologists use in the management of information for laboratory practice and patient care. Databases provide core structure and tools that enable pathologists to manage and analyze large amounts of information. Standards enable sharing of data among different health care information systems (ie, interoperability), which is necessary for patient care. Pathologists are ultimately responsible for the access to and safety of pathology information. Outcomes for Achievement Understand the relevance of informatics in pathology practice. Describe the difference between information technology (IT) and informatics and recognize how pathologists contribute to informatics initiatives. Explain the salient differences and similarities among pathology informatics, bioinformatics, public health informatics, health care information technology and health knowledge informatics. Use correct terminology to describe the major types and components of computer hardware, software, and computer networks. Conversant in the fundamentals of databases, including data types, fields, records, database structure, and mechanisms for querying data; understands how data storage affects data retrieval options. Define the types and roles of standards used in pathology, at a basic level. Understand the elements of data availability as a key part of security. Content 1.Definition of informatics 2.Relevance of informatics in pathology 3.Different types of informatics 4.The practice of informatics in pathology 1.Hardware 2.Software 3.Networks 4.Communications 5.Internet / Web 1.Database terminology 2.Structured vs. Unstructured data 3.Types of databases 4.Use of databases 1.Messaging protocols 2.Data models 3.Interoperability 4.Introduction to coding systems 1.Data protection and confidentiality 2.Data availability & integrity 3.Data backup & recovery 19

20. © 2014 APC/API/CAP. All rights reserved. Resource Options Lists content sources to support self-study or to inform the development of didactic materials Identifies recommended PIER resources, practical exercises and other optional resources Provides a detailed scheduling and progress tracker 20

21. © 2014 APC/API/CAP. All rights reserved. Outcomes Achievement Checklist Documents progress and accomplishments Completion of Essentials documents completion of corresponding ACGME informatics milestone level Final sign-off goes into resident’s file 21

22. © 2014 APC/API/CAP. All rights reserved. Alpha Testing and Deployment Testing Goals –Obtain feedback on PIER materials –Obtain feedback on implementation challenges and success tips Deployment Goals –Gather additional tools and resources that can be shared across programs –Build a cadre of programs that endorse PIER to foster deployment to additional institutions over time 22 Slide builds in 1 click

23. © 2014 APC/API/CAP. All rights reserved. Alpha Test Residency Programs Baystate Medical Center Cleveland Clinic George Washington University Medical University of South Carolina University of Buffalo University of Kentucky University of New Mexico University of Miami University of Pittsburgh University of Southern California University of Toledo University of Washington University of Vermont Vanderbilt University 23

24. © 2014 APC/API/CAP. All rights reserved. Alpha Test Residency Programs Baystate Medical Center Cleveland Clinic George Washington University Medical University of South Carolina University of Buffalo University of Kentucky University of New Mexico University of Miami University of Pittsburgh University of Southern California University of Toledo University of Washington University of Vermont Vanderbilt University 24

25. © 2014 APC/API/CAP. All rights reserved. Our Hope: Widespread PIER Adoption and Implementation PIER seeks to ensure that all pathology residents acquire the informatics knowledge and skills needed for the modern practice of pathology 25 We need your leadership for pathology residency programs to achieve this outcome together

26. 26 Q&A Bookmark PIER materials at: http://www.apcprods.org/PIER/ http://www.apcprods.org/PIER/

27. © 2014 APC/API/CAP. All rights reserved. Presentation Follow Up Direct any post meeting questions to Sue Plath, CAP Education Manager at splath@cap.org 27

28. © 2014 APC/API/CAP. All rights reserved. Thank You For Your Interest And Support